This proposal is focused on developing a reliable, valid, and reproducible imaging techniques and statistical methodology for segregation of various forms of Parkinsonism from healthy adults without Parkinsonism.

Individuals Diagnosed with Rapid-Eye Movement Behavior Disorder (RBD). Eligible individuals will have been diagnosed with RBD based on a sleep study prior to entering the study. This study does not pay for or support a sleep study.

Healthy Control group

Individuals are healthy, without a known neurologic disease.

Progressive Supranuclear Palsy Cohort

Individuals diagnosed with Progressive Supranuclear Palsy (PSP).

Parkinsonism - Undifferentiated

Individuals with any form of Parkinsonism, not meeting any of the above cohorts.

Detailed Description:

This proposal is focused on developing a reliable, valid, and reproducible imaging techniques and statistical methodology for segregation of various forms of Parkinsonism from healthy adults without Parkinsonism. We focus on early diagnosis of Parkinsonism, other tremor disorders, and determine how imaging might be used to improve diagnosis. The purpose of this protocol is to gather a multi-modal dataset to explore and validate the investigator's previous research findings in prior studies.

Eligibility

Ages Eligible for Study:

19 Years to 85 Years

Genders Eligible for Study:

Both

Accepts Healthy Volunteers:

Yes

Sampling Method:

Non-Probability Sample

Study Population

Subjects with PD, MSA-P, ET, or PSP will be recruited based on clinical criteria from the UAB Comprehensive Parkinson Disease and Movement Disorder Clinic located at The Kirklin Clinic at UAB. This center sees over 3,500 patients annually. Individuals with RBD will be recruited from the UAB University Hospital and UAB Highlands Sleep Disorders Center and will be identified through patient contact with a UAB Department of Neurology physician.

Criteria

Inclusion Criteria:

Healthy Control • Age 35-85

Parkinson Disease (PD) Age 35-85

Diagnosis of clinically definite PD made by a movement disorders specialist, with evidence of the following features:

Presence of bradykinesia and 1 or both of the following:

Rest tremor

Rigidity

Asymmetric Onset

Progressive motor symptoms

Levodopa responsive

Duration at least 1 but not more than 10 years

Hoehn and Yahr Stage 1-2

Progressive Supranuclear Palsy (PSP) Age 40-85

Diagnosis of clinically definite PSP, with the following features:

Gradually progressive disorder.

Onset after age 39

Supranuclear palsy* and postural instability with falls in the first year of disease onset*.

No evidence of other disease.

Parkinsonism of Other or Undetermined Cause (POC) Age 35-85

Diagnosis of parkinsonism of undetermined other other cause by a movement disorders specialist, with the following features:

Signs and symptoms of Parkinsonism including

Bradykinesia

Mixed or resting tremor

Rigidity

Characteristic deficits of gait and balance associated with Parkinsonism

Essential Tremor (ET) Age 35-85

Diagnosis of essential tremor, with the following features:

A 2+ postural tremor of at least 1 arm (a head tremor may also be present, but is not sufficient for diagnosis)

On examination, there must be

a 2+ kinetic tremor during at least 4 tasks, or;

a 2+ kinetic tremor on 1 task and a 3+ kinetic tremor on a second task; tasks include pouring water, using a spoon to drink water, drinking water, finger-to-nose, and drawing a spiral

If on examination, the tremor is present in the dominant hand, then by report, it must interfere with at least 1 activity of daily living.

REM Behavior Disorder (RBD) Age 25 - 85

Documented diagnosis of REM sleep behavior disorder (RBD) by a sleep medicine specialist, with the following clinical features:

Presence of REM sleep without atonia on polysomnography

At least one of the following conditions:

Sleep-related, behaviors by history (eg, dream enactment behavior)

Abnormal REM sleep behavior documented during PSG monitoring

Exclusion Criteria:

Healthy Control

Pregnancy

First-degree blood relative affected by PD

Neurodegenerative disease

History of repeated head injury, encephalitis, brain surgery, stroke, dementia, neuroleptic exposure, or serious medical illness that may interfere with participation.

Parkinson Disease (PD)

Any exclusion criteria that would exclude a healthy control patient

Atypical features indicative of a Parkinson-Plus disorder

Progressive Supranuclear Palsy (PSP)

Any exclusion criteria that would exclude a healthy control patient

Any finding atypical for PSP

Neuroradiologic evidence of relevant structural abnormality unrelated to appropriate changes known to be associated with PSP

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01547481